Abstract
The possible cerebral sparing effects of thiopental were evaluated in 32 severely asphyxiated neonates assigned to either a thiopental treatment (T) or a control (C) group which received standard medical therapy. All infants required assisted ventilation and had neurologic manifestations of asphyxia. Two of the following 3 criteria were also required: 1) Evidence of fetal distress 2) 5′ Apgar ≤4 and 3) Base Excess <-15 mEq/L at ≤1 hr of age. (T) was begun at a mean of 2 hrs. It was given as a constant infusion delivering 30 mg/kg within 2 hrs and was continued at a lower dose for 24 hrs. Seizures occurred in 76% (T) and 73% (C) at a mean age of 1.6 and 2.5 hrs, respectively. Hypotension requiring treatment occurred in 88% (T) and 60% (C). Developmental assessments were performed at 12 mos. of age or greater in 17 infants and at 6 mos. in 2.
There were no significant differences in neurologic, cognitive or motor outcomes between groups. Deteriorating performance over time was a consistent trend in both groups. Treatment of the severely asphyxiated neonate with thiopental at these dosages and postnatal age does not appear to have a cerebral sparing effect, and may be associated with significant hypotension.
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Goldberg, R., Bloom, F., Bauer, C. et al. 1390 THE USE OF BARBITURATE THERAPY IN SEVERE PERINATAL ASPHYXIA: A RANDOMIZED CONTROLLED TRIAL. Pediatr Res 19, 342 (1985). https://doi.org/10.1203/00006450-198504000-01414
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DOI: https://doi.org/10.1203/00006450-198504000-01414